In the past, primary health care has been favoured by central government as the site for the secondary prevention of mental health problems. (In the last chapter we noted that secondary prevention entails early screeening and ‘nipping problems in the bud’.) The rationale for this is that GPs are the designated gatekeepers of health services, and the first port of call for patients. Because of their ready accessibility, GPs are likely to have contact with most of their patients on an annual basis. Goldberg and Huxley (1980) suggested that over a period of a year, over 90 per cent of patients considered to be suffering from a mental health problem made contact with their GP. Recent estimates suggest that between 10.5 and 13.5 per cent of those considered to have severe and enduring mental health problems are managed at the primary care level (Callanan et al., 1997).
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